JAVIER ANTONIO PEREZ Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****56

License Status

INOPERATIVE

Business

First Name

JAVIER

Middle

ANTONIO

Last Name

PEREZ

Business Name

JAVIER ANTONIO PEREZ

Original Issue Date

11/09/2011

Effective Date

12/28/2011

Expiration Date

03/01/2014

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

12/28/2011